Spirituality (41)

Question 1

When planning care for an older client residing in your skilled nursing facility who is searching to make life meaningful, which nursing action would be most beneficial?

1. ) Assess for depression.
2. ) Diagnose and document that the client has “spiritual distress.”
3. ) Keep the client busy with social activities.
4. ) Explore with the client desired legacy.

Answer 1

4.) Explore with the client desired legacy.

Options 1 and 2 involve assessment and diagnosis, not planning. Option 3, simply keeping the client busy, does not necessarily contribute to feeling fulfilled or purposeful.

Question 2

A client’s wife asks the nurse to pray for her. What would be the best initial response for a nurse who believes in prayer?

1. ) “May I call the chaplain to come and pray with you?”
2. ) “I know your faith is important to you. It is to me, too. Let’s pray.”
3. ) “I’m happy to do that. For what would you like me to pray?”
4. ) “Isn’t it wonderful that we have a God with whom we can share our concerns?”

Answer 2

3.) “I’m happy to do that. For what would you like me to pray?”

The best initial response is to assess. Option 1 may be interpreted as distancing by the client. Option 2 inserts the nurse’s experience, which is generally inappropriate. Option 4 is not appropriate for someone in spiritual distress.

Question 3

A client is experiencing severe pain that cannot be controlled by analgesics. An appropriate intervention is full presencing, which involves which of the following?

1. ) Physical presence
2. ) Physical presence with mental awareness of the client
3. ) Physical, mental, and emotional presence
4. ) Physical, mental, emotional, and spiritual presence

Answer 3

3.) Physical, mental, and emotional presence

The key term is full. Option 1 would be inadequate; option 2 is only partial presencing; and option 4 is transcendent presencing.

Question 4

A client reports, “Cancer was the best thing that happened to me! It is making me appreciate life so much more.” This statement fits best with which NANDA diagnosis?

1. ) Spiritual Distress
2. ) Risk for Spiritual Distress
3. ) Readiness for Enhanced Spiritual Well-Being
4. ) Cognitive Denial

Answer 4

3.) Readiness for Enhanced Spiritual Well-Being

This client portrays no distress (option 1) or risk for distress (option 2), but rather the potential for enhanced spiritual health as a result of the transformative illness experience. Option 4 is not a valid diagnosis.

Question 5

A dying client states, “Part of what makes dying hard is that I don’t know for sure where I’m going. Nurse, what do you believe happens in the hereafter?” Which ethical guideline should guide your response?

1. ) Never share personal spiritual beliefs.
2. ) Share all spiritual beliefs, favoring none.
3. ) Share only your beliefs.
4. ) First assess for what prompts the client’s question.

Answer 5

4.) First assess for what prompts the client’s question.

Assessment is always the first step of the process of spiritual caregiving or any nursing activity. Options 1, 2, and 3 may not respect the spiritual beliefs of either the nurse or the client. While an assessment may lead the nurse to share personal beliefs, these are never urged on the client.

Question 6

Research evidence that supports providing spiritual care to older adults suggests that

1. ) Older adults are not very religious, but are very spiritual.
2. ) Older adults who are more religious have more illness.
3. ) Spiritual health and mental health are correlated.
4. ) Increased spiritual well-being is found among older adults

with depression.

Answer 6

3.) Spiritual health and mental health are correlated.

Many older adults are religious and spiritually aware. Options 1, 2, and 4 are disputed by recent research evidence.

Question 7

A client in the emergency department needs a transfusion of red blood cells. The client tells the nurse that, as a Jehovah’s Witness, blood transfusions are not permitted. Which statement would most likely lead to a resolution for this conflict?

1. ) You must accept the transfusion or else leave.
2. ) Don’t worry, you can ask for pardon after taking the blood.
3. ) May I please call a representative of your religion so that I

can understand your position better?

4.) I understand your position; I’ll be here with you as you die.

Answer 7

3.) May I please call a representative of your religion so that I can understand your position better?

Options 1, 2, and 4 are potentially uncaring or unethical. Jehovah’s Witnesses have a well-developed network of rep- resentatives who can be called to explain and explore medical options with their fellow believers and medical staff.

Question 8

An 88-year-old woman has just been admitted to a skilled nursing facility. She tells the nurse that she has been a Sunday school teacher and volunteers for many of her church’s projects. Which of the following NANDA diagnoses is most appropriate?

1. ) Risk for Spiritual Distress
2. ) Risk for Impaired Religiosity
3. ) Readiness for Enhanced Spiritual Well-Being
4. ) Impaired Religiosity

Answer 8

2.) Risk for Impaired Religiosity

Residing in the SNF likely will curb the client’s participation in her church. Options 1, 3, and 4 are incorrect because it is not known if the relocation or an alteration in religious practice will affect her spiritual well-being in either a negative or positive way.

Question 9

Which of the following thoughts made by a nurse illustrate a “wounded healer”?

1. ) “I didn’t need that much analgesic when I had abdominal surgery.”
2. ) “No pain, no gain!”
3. ) “If clients would choose a more positive attitude, they’d feel better.”
4. ) “I felt scared when I had surgery; maybe this client feels similarly.”

Answer 9

4.) “I felt scared when I had surgery; maybe this client feels similarly.”

Recognizing personal emotional responses to events that parallel those experienced by a client, allows a nurse to identify an empathic response to a client’s spiritual or emotional need. Options 1, 2, and 3 fail to show a nurse drawing deep to recognize in- ner experience that can inform empathy.

Question 10

The mother of a pediatric client states, “I can’t understand why God would allow this to happen to my innocent child!” Which NANDA diagnosis is most accurate?

1. ) Spiritual Distress related to search for meaning of child’s illness
2. ) Impaired Religiosity related to anger at God
3. ) Ineffective Coping related to anger
4. ) Risk for Spiritual Distress related to threatened sense of hope

Answer 10

1.) Spiritual Distress related to search for meaning of child’s illness

Although the mother is arguably angry, it is unknown whether this anger is impairing her religiosity or her coping. More data are needed before determining that either option 2 or 3 is the best diagnosis. The mother is experiencing distress versus being at risk for it (option 4).